Infection as a Key Determinant of Readmission in Stroke Patients: A Systematic Review and Meta-Analysis

Accurately identifying the relationship between infection and the readmission of stroke patients leads to emphasis more the corresponding strategies. We aimed to determine the relationship between infection and readmission in stroke patients.

This systematic review and meta-analysis was based on PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including PubMed, Web of Science, CINAHL, Scopus, and Google Scholar, using keywords such as "stroke," "readmission," "recurrence," "re-hospitalization," and "infection" up to 2024. The rate of readmissions due to infection, along with the Odds Ratio (OR) for infection, was calculated using a random effects model via Comprehensive Meta-Analysis V.2 software.

Based on the reviewed studies, the 30-day readmission rate of stroke patients due to infection ranged from 6.5% to 30.0% and the one-year readmission rate ranged from 5.1% to 24.5%. Also, infection is an important risk factor in the readmission of stroke patients based on cohort studies (RR 1.38, 95% CI: 1.16-1.65, P<0.001), case-control (OR 1.68, 95% CI: 1.16-2.42, P= 0.006) and descriptive-analytical (OR 1.31, 95% CI: 1.07-1.59, P= 0.008).

The readmission rate of stroke due to infection is high and tackling infection-related readmissions in stroke patients necessitates a holistic strategy that combines clinical care, technological advancements, and education. More studies are needed in this field.